Role of inj magnesium sulfate in severe neonatal hypocalcaemia.


It is used for pediatric acute nephritis and to prevent seizures in severe pre-eclampsia, eclampsia, or toxemia of pregnancy.
Hypomagnesemia    Infants, children and adolescents     Dose expressed as magnesium sulfate  IV, IO  25-50 mg /kg/dose every 6h for 2-3 doses, then recheck serum concentration  Max dose: 2,000 mg/dose     Dose expressed as elemental magnesium  IV  2.5-5 mg/kg/dose every 6h for 2-3 doses   Constipation, occasional    Children 6 to < 12 yrs  Oral   1-2 level teaspoons of granules dissolved in 8 ounces of water  May repeat in 4-6h  Do not exceed 2 doses per day    Children ≥ 12 yrs and adolescents  Oral   2-4 level teaspoons of granules dissolved in 8 ounces of water  May repeat in 4-6h  Do not exceed 2 doses per day  Parenteral nutrition, maintenance requirement   Dose expressed as elemental magnesium     Infants and children < 50 kg  IV   0.3 - 0.5 mEq/kg/day    Children > 50 kg and adolescents  IV   10 - 30 mEq/day  Torsade de pointes or VF/pulseless VT associated with torsade de pointes   Dose expressed as magnesium sulfate     Infants, children and adolescents  IV, IO  25 - 50 mg/kg/dose  Max dose: 2,000 mg /dose   Asthma, acute refractory status   Dose expressed as magnesium sulfate    Infants, children and adolescents  IV  25 - 75 mg/kg/dose as a single dose  Max dose: 2,000 mg/dose  Mild to moderate asthma    Single dose     Children ≥ 5 yrs and adolescents  Oral inhalation: Nebulization (prepared from injectable formulation), given with a nebulized beta2-agonist (e.g. albuterol)  2.5 mL isotonic magnesium sulfate solution mixed with albuterol 2.5 mg (0.5 mL) as a single dose  Magnesium was supplied as a 6.3% solution of magnesium heptahydrate, which is equivalent to anhydrous magnesium sulfate 3.18%  Doses were nebulized with 8 to 10 L/min of oxygen  Moderate to severe asthma  Three-dose series    Children ≥ 2 yrs and adolescents ≤ 16 yrs  Oral inhalation   151 mg isotonic magnesium sulfate mixed with albuterol and ipratropium was administered every 20 min for 3 doses to patients with severe acute asthma who did not respond to standard inhalation treatment.
Valuable opinion
Magnesium deficiency impairs PTH secretion thus causes hypocalcemia.....hypocalcemic seizures with concurrent hypomagnesia should be treates with 50 to 100 mg/kg of mag sulphate iv given over 1 to 2 hrs...infuse slowly and monitor heart rate..
In hypocalcemia refractory seizure there is mostly hypo magnesemia thats why inj. Mgso4 is If there is hypomagnesemia then only its requires...
Low level of mgsulph reduces the activity of PTH hormone and long term deficiency inhibits the release of PTH
If hypocalcaemic seizures persist Mag sulphate is tried and effective.

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